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Functional Med > Mid term > Flashcards

Mid term Flashcards

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1
Q

deficiency test for Vitamin A

A

vitamin A serum, (L)

beta-carotene -serum(L)

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2
Q

deficiency test for B1 (thiamin)

A

alpha-keto acids - urine, (H)

Erythrocyte transketolase index - RBC (H)

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3
Q

deficiency test for B2 (riboflavin)

A

(H)
alpha-keto acids - urine,
Ethylmalonate - urine
EGR active coefficient - RBC

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4
Q

deficiency test for B3 (niacin)

A

n-methylnicontinamide -urine (H)

lactate and pyruvate - urine (H)

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5
Q

deficiency test for B5 (pantothenate)

A

alpha-keto-acids - urine (H)

pantothenic acid - urine(L)

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6
Q

deficiency test for B6 (pyridoxine)

A 
(H)
xanthurenate - urine 
kynurenate - urine
homocysteine - plasma
EGOT index - RBC
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7
Q

deficiency test for Vitamin B12 (cyanocobalamin)

A

methylmalonate - urine (H)
homocysteine - plasma (H)
vitamin B12 serum (L)

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8
Q

deficiency test for tetrahydrobiopterin (BH4)

dihydrobiopterin (BH2)

A

Bh4 - plasma (L)
Phe or Phe/Tyr ratio - plasma (H)
BH4 loading test plasma (drop >50%)

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9
Q

deficiency test for Vitamin C

A

(L) Vitamin C Serum, leukocyte or urine after 500 mg of oral load

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10
Q

deficiency test for Vitamin K

A

PIVKAII - serum (L)
undercarboxylated osteocalcin - serum (H)
Vitamin K serum - (L)
Prothrombin plasma (H)

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11
Q

deficiency test for Vitamin D

A

25-hydroxyvitamin D serum (L)

bone specific collagen fragments - urine (H)

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12
Q

deficiency test for Vitamin E

A

tocopherol - serum (L)

tocopherol/triglyceride serum (L)

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13
Q

deficiency test for Biotin

A

beta-hydroxyisovalerate -urine (H)

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14
Q

deficiency test for folate

A 
homocysteine plasma (H)
folate serum (L)
folacin RBC (L)
macrocytic anemia whole blood (positive)
neutrophil hypersegmentation - whole blood (positive)
Formiminoglutamate (FIGLU) urine (H)
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15
Q

deficiency test for caritine

A

adipate, suberate ethylmalonate - urine (H)

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16
Q

deficiency test for coenzyme Q10

A 
coenzyme Q10 serum (L)
succinate urine (H)
hydroxymethylglutarate urine (H)
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17
Q

deficiency test for lipoic acid

A

lactate and pyruvate serum or urine (H)

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18
Q

deficiency test for choline

A

choline plasma (L)

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19
Q

assessment of calcium

A

hair, urine

bone resorption markers, serum 25-hydroxyvitamin D, PTH

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20
Q

assessment of magnesium

A

RBC, whole blood, plasma, serum, urine

Refractory hypokalemia

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21
Q

assessment of potassium

A

RBC, serum, hair

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22
Q

assessment of iron

A

ferritin

total iron binding capacity, transferrin saturation, hemoglobin, hematocrit

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23
Q

assessment of zinc

A

RBC, hair, plasma

delta 6 desaturase activity (LA:GLA) Zn metallothionein

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24
Q

assessment of copper

A

RBC, serum ceruloplasmin

elevated urinary HVA/VMAratio; bone resorption markers

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25
assessment of maganese
RBC | abnormal urinary ammonia markers, elevated arginine: ornithine ratio
26
assessment of selenuim
serum, whole blood, hair | selenoprotein P, urinary selenosugars
27
assessment of molybdenum
hair | elevated xanthine uric acid ratio
28
assessment of chromium
RBC, urine, hair | insulin, blood glucose
29
assessment of iodine
urine, | serum T3, T4, TSH, blood spot thyroglobulin
30
assessment of boron
serum, urine, hair | bone resorption markers
31
assessment of nickel
urine, plasma hair
32
assessment of lithium
serum, plasma, urine, hair
33
assessment of vanadium
whole blood, serum, urine | blood glucose, blood lipids
34
assessment of strontium
serum, urine, hair | bone resorption markers
35
H glutamic acid (Glu) give:
alpha KG
36
H glutamine (Gln) give:
alpha KG, B6
37
H arginine (Arg) give:
Mn
38
L arginine (Arf) give:
Arg
39
H asymmetric dimethylargininge give
Arg
40
H citrulline give
Mg, alpha KG,
41
H ornithine (Orn) give
Mg, alpha KG
42
L aspartic acid (Asp) give
alpha KG
43
H aspartic acid (Asp) give
Mg, Zn
44
Urea cycle and nitrogen management AA;s
Arg, asymmetric dimethylarginine, citrulline, ornithine, aspartic acid, asparagine
45
EAA for proteins and energy
isoleucine, leucine, valine, threonine, histidine, lysine, alpha aminoadipic acid
46
H isoleucine ((Ile) give
B6, check for insulin insensitivity
47
H leucine (Leu) give
B6, check for insulin insensitivity
48
H valine (Val) give
B6, check for insulin insensitivity
49
H threonine (Thr) giver
B6
50
H histidine (His) give
B6
51
L histidine (His) give
folate, His
52
H lysine (lys) give
Vitamin C, niacin (B3), B6, Fe (confirm with ferritin),
53
L lysine (lys) give
carnitine (check for excessive Arg intake)
54
H alpha aminoadipic acid give
B6, alpha KG,
55
Neurotransmitters and precursors (AAs)
phenylalanine, tyrosine, tryptophan, alpha amino n butyric acid, gamma aminovutyric acid (GABA)
56
H phenylalanine (Phe) give
Fe, tetrahydrobiopterin, Vitamin C, Low Phe diet
57
H tyrosine (Tyr) give
cu, Fe, vitamin C
58
L tyrosine (tyr) give
Fe, Tyr
59
L tryptophan (Trp) give
5-HTP
60
H tryptophan (Trp) give
Niacin, B6, Fe, Cu
61
L alpha-Amino-N-butyric acid give
alpha KG, B6
62
H Methionine (Met) give
B6, alpha KG
63
L cystine (Cys) give
NAC
64
H homocystine (Hcys) give
B6, folate, B12, Betaine
65
H Cystathionine give
B6
66
L Taurine (Tau) give
B6
67
H Taurine (Tau) give
multiple antioxidants
68
AA precursors of heme Nucleotides and cell membranes
Gly, Ser, Sarcosine
69
H Glycine (Gly) give
folate, B6, B2, B5
70
L Serine (Ser) give
B6, folate, Mn
71
H Serine give
Thr, BCAAs
72
H sarcosine give
Thr, BCAA's
73
H Alanine (Ala) give
B6
74
H Ethanolamine give
Mg
75
H Phosphoethanolamine give
S-Adenosylmethionine
76
H Phosphoserine give
Mg
77
L Proline (Pro) give
alpha KG, His
78
H Hydroxyproline (HPro) give
Vitamin C, Fe
79
H Proline (Pro) give
Vitamin C, Niacin
80
H Hydroxylysine (HLys) give
Vitamin C, Fe
81
H beta alanine give
lactobacillus and bifidobacteria sp, B6
82
H beta aminosbutyric acid
B6, B12
83
H Anserine give
Zn
84
H carnosine give
Zn
85
H 1-mthylhistidine give
vitamin E
86
H 3-methylhistidine give
BCAA, antioxidants (if evident muscle wasting)
87
Organic Acids of fatty acid oxidation
adipate, suberate, ethylmalonate
88
H Adipate, suberate, or ethylmalonate give
l-carnitine L-lysine (if low) B2
89
Aerobic/anaerobic energy production organic acids
pyruvate, lactate,
90
H pyruvate give
B1, B complex, | with high lactate give lipoic acid
91
H lactate give
CoQ10
92
H beta hydroxybutyrate give
chromium picolinate
93
H Citrate give
arginine
94
L citrate give
aspartic acid, magnesium
95
H cis-asonitate give
cysteine, check for iron deficiency
96
H isocitrate give
lipoic acid, Mg, Mn
97
H alpha ketoglutarate
give B complex, lipoic acid
98
H succinate give
CoQ10, lipoic acid
99
H fumarate give
CoQ10, Mg
100
H malate give
CoQ10, B3
101
H/L Hydroxymethylglutarate
CoQ10,
102
citric acid cycle intermediates
citrate, cis-aconitate, isocitrate, alpha KG, succinate, fumarate, malate
103
H alpha ketoisovalerate give
B complex, lipoic acid
104
H alpha ketoisocaproate give
B complex, lipoic acid
105
H alpha - keto - beta - methylvalerate give
B complex, lipoic acid
106
H formiminoglutamate (FIGLU) give
folic acid
107
H beta hydroxyisovalerate give
biotin, Mg
108
H methylmalonate or propionate give
B12
109
L,H Vanilmandelate give
tyrosine, phenylalanine hydroxylase cofactors as needed | contraindicated for patients taking MAO inhibitors
110
L,H homovanillate give
tyrosine, phenylalanine hydroxylase cofactors as needed | contraindicated for patients taking MAO inhibitors
111
L,H 5- Hydroxyindolacetate
5-hydroxytryptophan (5-HTP), Mg, B6
112
H kynurenate give
B6, Mg
113
H Quinolinate give
Mg
114
H p-Hydroxyphenyllactate give
Vitamin C to bowel tolerance
115
8-hydroxy-2'-deoxyguanosine give
antioxidants (C,E, lipoic acid)
116
H homogentisate give
low protein diet, vitamin C
117
H 2-methylhippurate give
avoidance of xylene; glycine B5
118
H orotate give
arginine, a-KG, Aspartic acid, magnesium
119
H glucarate give
glysine, GSH, NAC
120
H alpha hydroxybutyrate, pyroglutamate give
NAC, glutathione, Taurine
121
L sulfate give
NAC, glutathione, Taurine
122
detoxification indicators (organic acids)
2-methylhippurate, orotate, glucarate, alpha hydroxybutyrate, pyroglutamate, sulfate
123
2-methylhippurate, what metabolic pathway?
hepatic conjugation
124
orotate what metabolic pathway?
ammonia clearance, pyrimidine synthesis
125
glucarate what metabolic pathway?
detox, liver enzyme induction
126
alpha hydroxybutyrate, pyroglutamate what metabolic pathway?
hepatic GSH synthesis
127
sulfate what metabolic pathway?
Renal amino acid recovery
128
detoxification what metabolic pathway?
detox and anti-oxidant functions
129
H benzoate give
glycine, vitamin B5, glutamine, digestive aids and free form amino acids to help normalize gut permeability
130
H hippurate, phenylacetate, phenylpropionate, p-cresol, p-hydroxybenzoate, p-hydraxyphenylacetate, tricarballylate, D-lactate, 3,4 dihydroxyphenylpropionate or D-arbinitol give
glutamine, digestive aids and free form amino acids to help normalize gut permeability

Functional Med (2 decks)

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